In defence of birth plans

Tara Moss

Skin-to-skin contact after birth may improve the breastfeeding relationship.

"My personal view of birth plans is that they’re most useful when you set them on fire and use them to toast marshmallows. But there are some women who live for them: I call them Birthzillas because just like a Bridezilla focusses on the wedding not the marriage, The Birthzilla appears more interested in having a birth experience than a baby," writes Mia Freedman in the Sunday Telegraph in a piece on the decidedly ugly game of ‘My Birth Was Better Than Yours’.

Birthzillas, Bridezillas and perhaps all ‘Zillas’ are bad news. It’s amusing stuff, but the thing is, birth plans are helpful for many parents, and an increasing number of obstetricians and midwives request them. There are a number of reasons for this.

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The majority of Australian women choose to birth in hospital and all hospitals do not have the same protocols. It is easy to imagine they would, but they don’t, not from state to state and not even from hospital to hospital in the same city. Even individual health practitioners in the same facility sometimes do not follow the same protocols.

For instance, unless specifically requested, many hospitals do not automatically offer valuable skin-to-skin time, where baby is simply placed on mother’s chest straight after birth for about an hour, despite research showing substantial health benefits including increased success with breastfeeding and mother-baby bonding. (I recommend this very beautiful experience and thankfully most hospitals will offer it if requested, even in circumstances where mum has given birth by caesarean.)

Things like skin-to-skin are the sorts of thing you can put in your birth plan, along with other important requests, including who you would like present during birth, "I’d like my husband to be present to support me", "By no means let my in-laws into the birthing suite" etc. If you want those things but don’t express them, you may find bub whisked away for weighing and washing before you get the opportunity for skin-to-skin or your first breastfeed, and you might find your well-meaning mum-in-law wandering in when you aren’t ready for company.

Women have the right to control what is done to their bodies, always, including during the intense process of birth

Do you want pain medication offered, or would your rather ask for it yourself? Do you want to avoid certain optional medical procedures, like an episiotomy? Do you want cord blood saved for cord banking? The list goes on.

Women have the right to control what is done to their bodies, always, including during the intense process of birth when the body is arguably most out of our individual control. Informed consent is important in birth, as it is in our sexual experiences, in breastfeeding, and in the sadder times when illness and death take over. During these times it pays to be particularly clear about our wishes and requests, to ourselves, but most importantly to those who will be in that experience with us – our carers, our partners, our doctors, our families, our friends.

Clearly communicated requests about what we would or would not like to have done to our bodies is important, which is why birth plans are recommended by many obstetricians and midwives. These requests are not set in stone, of course, but it pays to write our requests down and chat clearly with our chosen health practitioner about those requests beforehand because: a) we then don’t have to worry about what unknown things will be done to us in various circumstances, as the different scenarios will have been discussed clearly beforehand, b) our carers will know what our wishes are and can communicate them to all of the staff who will be involved in our care, and c) we are actively involved in the decisions made about your bodies and the bodies of our newborn children.

Life is not predictable. There are no guarantees. But it pays to learn, to hope and to plan.

Tara Moss is the UNICEF Patron for Breastfeeding for the Baby Friendly Health Initiative